Pathogenic Mechanisms in Primary Progressive MS

Primary progressive (PP) multiple sclerosis (MS) occurs in approximately 10% of patients and is characterized by the lack of relapses. Prior in vitro studies have shown that cerebrospinal fluid (CSF) from patients with PPMS can lead to apoptosis of neurons and transcription abnormalities in oligodendrocyte precursor cells. This study was a further investigation of clinical and pathologic effects of CSF from 17 patients with PPMS, 13 with relapsing-remitting (RR) MS, and 12 with secondary progressive (SP) MS.

After injecting CSF samples into the cervical subarachnoid space in mice, the investigators observed spinal cord demyelination and axonal damage in mice injected with PPMS CSF but not RRMS or SPMS CSF. The PPMS CSF also induced reactive …